Uncemented total hip arthroplasty in patients 50 years of age or younger.
The results of a consecutive series of uncemented total hip arthroplasties in patients 50 years or younger are reviewed. There were 41 total hip arthroplasties in 36 patients at an average follow-up period of 5.3 years. Average patient age was 42 years at the time of implantation. Preoperative Harris hip score (HHS) averaged 39/100; the final HHS averaged 93. Radiographic evaluation revealed that the femoral stems were all solid, with no progressive subsidence, reactive lines, or osteolysis. Twenty of the hips (49%) demonstrated evidence of polyethylene wear. There was significant acetabular osteolysis in 12 of these 20 hips. Five of the acetabular cups were definitely loose; 1 was possibly loose. Three of the patients underwent revision surgery for acetabular loosening and/or osteolysis. It is concluded from this study that the femoral stem is excellent but that the original acetabular component and polyethylene locking mechanism are poor and made even worse with the use of a titanium femoral head.
Dowdy
P A
PA
Central Florida Orthopaedics and Sports Medicine Institute, Haines City, Davenport 33837, USA.
Rorabeck
C H
CH
Bourne
R B
RB
D000077:Acetabulum / Q000000981:diagnostic imaging; D000328:Adult; D019644:Arthroplasty, Replacement, Hip; D001843:Bone Cements; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006622:Hip Prosthesis / Q000009:adverse effects; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D010014:Osteolysis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D011095:Polyethylenes / Q000009:adverse effects; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies
D001843:Bone Cements; D011095:Polyethylenes